Adapting Best Practices in CBT for Deaf and Hearing Persons With Language and Learning Challenges

This article presents the work of a specialty psychiatric unit for deaf people in adapting best practices in cognitive-behavioral therapy (CBT) for deaf and hearing mental health clients who have severe language and learning challenges. Research cited shows that large numbers of deaf people referred to psychiatric hospitals have severe language impairments (in their best language, usually American Sign Language; ASL), related mainly to inadequate exposure to ASL as a child. These language impairments accompany other kinds of language and cognitive problems ound also in hearing persons. Clinicians on the unit adapted the constructivist narrative CBT of Meichenbaum so that it could inform the treatment of these clients. Specifically, the treatment is oriented around the acquisition and development of psychosocial skills. These skills are understood developmentally; that is, early and simple skills develop into more complex coping and conflict resolution skills. All the skills are presented and taught using hundreds of specially developed pictures. Emphasis is placed on interventions that work at a sensorimotor and concrete operational level. A case study is presented along side of a theoretical discussion.